Ekstrak buah makasar (Brucea Javanica (L) Mer.) meningkatkan kadar enzim Superoksida Dismustase (SOD) mencit (Mus musculus) Swiss Webster jantan yang diinduksi paraquat

Background: Aging is a biological process where one of the contributing factors is oxidative stress due to free radicals in the body. Paraquat is an example of free radicals that are often used by oil palm plantation farmers in Bengkulu, which can trigger the aging process by reducing the enzyme Superoxide Dismutase (SOD). The provision of fruit extract of Makassar (Brucea javanica (L) Mer) contains bioactive compounds that can function as antioxidants by increasing SOD levels in the body. This study aims to prove that the fruit extract can increase the levels of SOD of male Swiss Webster mice induced by paraquat.

Methods: In vivo experimental research with randomized pretest-posttest control group design was conducted on 14 Swiss Webster mice (Mus musculus) as research subjects. The research subjects were then divided into 2 groups, namely the control and the treatment group (20 mg/kgBW/day (P1) for 14 days). Data were analyzed using SPSS version 17 for Windows.

Results: The results showed that there was no significant increase in the mean of SOD levels either before (16.97±1.45 U/ml) or after (17.07±1.89 U/ml) treatment in the P0 group (p> 0.05). However, in the P1 group that was given paraquat induction coupled with Makassar fruit extract at a dose of 20 mg/kgBW/day for 14 days, it showed that there was a significant increase in the mean SOD levels from 17.18±1.69 U/ml to 67.56±3.65 U/ml (p <0.05).

Conclusion: Provision of Makasar fruit extract at a dose of 20 mg/kgBW/day for 14 days was found to significantly increase the mean SOD levels in Swiss Webster male mice induced by paraquat.

 

Latar Belakang: Penuaan adalah suatu proses biologi dimana salah satu faktor penyebabnya adalah stres oksidatif akibat radikal bebas yang terjadi di dalam tubuh. Paraquat merupakan salah satu contoh radikal bebas yang sering digunakan oleh petani perkebunan sawit di Bengkulu dimana dapat memicu proses penuaan melalui penurunan kadar enzim Superoksida Dismutase (SOD). Pemberian ekstrak buah makasar (Brucea javanica (L) Mer) mengandung senyawa bioaktif yang dapat berfungsi sebagai antioksidan dengan meningkatkan kadar SOD dalam tubuh. Penelitian ini bertujuan untuk membuktikan bahwa ekstrak buah makasar dapat meningkatkan kadar SOD mencit jantan swiss Webster yang diinduksi paraquat.

Metode: Penelitian eksperimental secara in vivo dengan rancangan randomized pretest-posttest control group design dilakukan terhadap 14 ekor mencit (Mus musculus) swiss Webster sebagai subjek penelitian. Subjek penelitian kemudian dibagi menjadi 2 kelompok, yaitu kelompok kontrol dan kelompok perlakuan (20 mg/kgBB/hari (P1) selama 14 hari). Data dianalisis dengan SPSS versi 17 untuk Windows.

Hasil: Hasil penelitian menunjukan bahwa tidak terdapat peningkatan bermakna rerata kadar SOD baik sebelum (16,97±1,45 U/ml) atau setelah (17,07±1,89 U/ml) perlakuan pada kelompok P0 (p>0,05). Akan tetapi, pada kelompok P1 yang diberikan induksi paraquat ditambah dengan ekstrak buah makasar dengan dosis 20 mg/kgBB/hari selama 14 hari menujukkan terdapat peningkatan secara bermakna rerata kadar SOD dari 17,18±1,69 U/ml menjadi 67,56±3,65 U/ml (p<0,05).

Kesimpulan: Pemberian ekstrak buah makasar dosis 20 mg/kgBB/hari selama 14 hari diketahui dapat meningkatkan rerata kadar SOD secara bermakna pada mencit jantan swiss Webster yang diinduksi paraquat.

Hubungan derajat keparahan preeklamsia dengan kejadian asfiksia neonatorum di Rumah Sakit Umum Negara periode Januari 2019 - Januari 2020

Background: Preeclampsia is one of complication in pregnancy and the causal of maternal morbidity and mortality. There is an impairment of blood flow to placenta vascularization which lead to tissue hypoxia and increase the chance to develop asphyxia neonatorum. The aim of this study is to know the correlation between severity of preeclampsia and asphyxia neonatorum in Negara General Hospital on January 2019-January 2020.

Methods: The design of this study was observational analytic cross-sectional. Woman who was diagnosed with preeclampsia and delivered in Negara General Hospital, Jembrana between January 2019-January 2019 were included by total sampling. Data, such as maternal age, parity, mode of delivery, severity of preeclampsia and asphyxia neonatorum, were collected from medical record. Then, data was analyzed bivariate using chi-square test and prevalence ratio (PR) analysis was conducted. The value of p<0,05 was considered significant.

Results: As many as 170 women with preeclampsia were recruited in the study. The prevalence of birth asphyxia was 71,2% in this study. Majority of women were 20-35 years old (67,1%), parity 2-3 (50,6%), had assisted-delivery (74,7%) and severe preeclampsia (72,9%). A bivariate analysis showed the prevalence of asphyxia neonatorum was significantly higher in assisted-delivery (PR=2,541, p=0,036; 95% CI=1,044-6,188) and severe preeclampsia (PR=2,346, p=0,045; 95% CI=1,044-5,486).

Conclusion: Mode of delivery and severity of preeclampsia is associated with asphyxia neonatorum. Early identification and proper antepartum management were essential to prevent asphyxia neonatorum in mother with risk factors.

 

 

Latar Belakang: Preeklampsia adalah salah satu komplikasi kehamilan dan penyebab morbiditas dan mortalitas maternal. Kondisi ini menyebabkan gangguan aliran darah ke vaskularisasi plasenta sehingga dapat menimbulkan hipoksia jaringan dan berpotensi menyebabkan asfiksia neonatorum. Penelitian ini bertujuan untuk mengetahui hubungan antara derajat keparahan preeklampsia dan kejadian asfiksia neonatorum di Rumah Sakit Umum (RSU) Negara.

Metode: Penelitian ini menggunakan rancangan analitik observasional desain potong-lintang. Sampel penelitian adalah wanita yang terdiagnosis dengan preeklampsia dan menjalani persalinan di RSU Negara, Jembrana dalam kurun waktu Januari 2019 – Januari 2020 yang dikumpulkan secara total sampling. Data berupa usia maternal, paritas, metode persalinan, derajat preeklampsia, dan kejadian asfiksia neonatorum didapatkan dari rekam medis. Data kemudian dianalisis secara bivariat dengan uji chi-square dan dilakukan analisis prevalence ratio (PR). Hubungan dikatakan signifikan apabila diperoleh nilai p<0,05.

Hasil: Penelitian ini mengikutsertakan 170 pasien yang memenuhi kriteria inklusi dan eksklusi. Sebanyak 71,2% kejadian asfiksia neonatorum tercatat dalam penelitian ini. Mayoritas ibu berusia 20-35 tahun (67,1%), memiliki paritas 2-3, melakukan persalinan dengan tindakan (74,7%), dan mengalami preeklampsia berat (72,9%). Berdasarkan hasil uji bivariat, prevalensi kejadian asfiksia neonatorum lebih tinggi pada persalinan dengan tindakan (PR=2,541, p=0,036; Confidence interval (CI) 95% 1,044-6,188) dan preeklampsia berat (PR=2,346, p=0,045; CI 95% 1,044-5,486).

Simpulan: Metode persalinan dan derajat preeklampsia berhubungan dengan kejadian asfiksia. Deteksi dini dan penanganan anterpartum yang tepat dapat membantu mencegah kejadian asfiksia neonatorum pada ibu yang berisiko.

Hubungan faktor bakteriuria dan leukosituria dengan kejadian persalinan Preterm Premature Rupture of Membrane (PPROM) dan Premature Rupture of Membrane (PROM) di RSUD Mangusada, Badung tahun 2018-2019

Background: Preterm labor is one of the most contributors to morbidity and mortality in perinatal and neonatal. Several factors may cause preterm labor with infection as pathophysiology, including urinary tract infection (UTI), to initiate inflammation cascade. This study aims to determine the relationship between bacteriuria and leukocytic factors with the incidence of preterm premature rupture of membrane (PPROM) and premature rupture of membrane (PROM) delivery at Mangusada Hospital, Badung in 2018-2019.

Methods: A cross-sectional observational research toward 92 expectant within PPROM and 92 expectant within PROM was done to know the relation between leukocyturia and bacteriuria with the risk of PPROM and PROM. The research variable involves secondary data from urinalysis of leukocyturia and bacteriuria by flowcytometry Sysmex UX-2000 taken from the patient’s registry at maternity room Mangusada Hospital, Badung in 2018-2019. Data were analyzed using SPSS version 17 for Windows.

Results: The study results show leukocyturia in PPROM is about 93.42% and 6.5% in PROM, while 71.67% bacteriuria within PPROM and 28.33% within PROM. There’s no significant relationship between bacteriuria result in PPROM and PROM (p=0.247), but there’s considerable relation between leukocyturia within PPROM and PROM (p=0.000).

Conclusion: It can be concluded that there’s a significant relationship between leukocyturia within PPROM and PROM.

 

 

Latar Belakang: Persalinan preterm merupakan salah satu penyumbang besar morbiditas dan mortalitas perinatal dan neonatal. Berbagai faktor dapat menyebabkan persalinan preterm dengan mekanisme patofisiologi terutama infeksi, salah satunya infeksi saluran kemih (ISK), yang dapat menginisiasi kaskade inflamasi. Penelitian ini bertujuan untuk mengetahui hubungan faktor bakteriuria dan leukosituria dengan kejadian persalinan Preterm Premature Rupture of Membrane (PPROM) DAN Premature Rupture of Membrane (PROM) di RSUD Mangusada, Badung tahun 2018-2019

Metode: Penelitian observational cross-sectional terhadap 92 ibu hamil bersalin dengan PPROM dan 92 ibu dengan PROM dilakukan untuk mengetahui hubungan antara bakteriuria dan leukosituria dengan risiko terjadinya persalinan PPROM dan PROM. Variabel penelitian berupa data sekunder hasil urinanalisa flowcytometry Sysmex UX-2000 (leukosituria dan bakteriuria) diambil dari register pasien di ruang bersalin Rumah Sakit Daerah Mangusada Badung tahun 2018-2019. Data dianalisis dengan SPSS versi 17 untuk Windows.

Hasil: Hasil penelitian menunjukkan leukosituria pada PPROM sebanyak 93.42% dan 6.5% pada PROM, sedangkan bakteriuria sebanyak 71.67% pada PPROM dan 28.33% pada PROM. Tidak ada hubungan yang bermakna antara kejadian bakteriuria dengan persalinan PPROM dan PROM (p=0,247). Namun, ditemukan hubungan yang bermakna antara leukosituria dengan persalinan PPROM dan PROM (p=0,000).

Kesimpulan: Dapat disimpulkan terdapat hubungan signifikan antara leukosituria dengan persalinan PPROM dan PROM.

Association between transformational leadership, organizational commitments, and application of Total Quality Management (TQM) to employee performance in Sanglah General Hospital, Bali, Indonesia

Background: Employee performance results from work achieved by an employee in quality and quantity in carrying out tasks in accordance with the responsibilities given. Good employee performance increases hospital customer satisfaction. This study aims to determine the relationship between transformational leadership, organizational commitment, and the application of Total Quality Management (TQM) with employee performance at Sanglah Central General Hospital.

Methods: A cross-sectional study was conducted among 87 samples. Samples in each installation/unit that fulfilled inclusion criteria were selected using proportional random sampling. Data were analyzed using univariate, bivariate (chi-square), and multivariate (logistic regression) by SPSS version 20 for Windows.

Results: Most employees perceived good in transformational leadership (67.8%), good organization commitment (55.2%), good application of TQM (75.9%), and good employee's performance (65.5%). The bivariate analysis shows a significant association between transformational leadership (p=0.001), organization commitment (p=0.001), and application of TQM (p=0.010) with employees' performance in Sanglah General Hospital. However, according to the multivariate analysis, a statistically significant association variable is organizational commitment (OR=547.96; 95% CI=4.922-613.673; p=0.001).

Conclusion: Factors associated with the employee's performance in Sanglah Hospital are transformational leadership, organizational commitment, and TQM. Therefore, stakeholders in the hospital should consider the loyalty of employees in determining policies to improve service quality continuously.

Pengaruh puasa berselang terhadap berat badan pada mahasiswa Program Studi Pendidikan Dokter Fakultas Kedokteran Universitas Udayana

Background: Body weight is used as a measure of body mass in kilogram (kg). The way which is effective for weight loss is a lifestyle changes like diet and exercise. Besides low calorie diet, we can do intermittent fasting to prevent overweight and obesity.

Aim: This research aims to know the effect of intermittent fasting on body weight in young adult group.

Methods: This research uses pretest-posttest control group design which was conducted during Ramadhan fasting in 2017 in the Department of Physiology, Faculty of Medicine, Udayana University. The subject is divided into two groups, namely fasting group and unfasting group as many as 40 people, respectively. The data include weight before and after fasting.

Results: Normality test obtained both fasting groups with p=0.326 and unfasting one with p=0.317, so that both groups are homogenous. Paired-sample t test on the weight for the beginning and end of the fasting group obtained the value of p=0.000, whereas in unfasting group obtained 0.149.

Conclusion: Intermittent fasting affects early weight loss and final body weight on fasting group consequently. As for the unfasting group, it was obtained no significant distinction between initial weight compare with latest weight.

Latar belakang: Berat badan digunakan sebagai ukuran massa tubuh dalam kilogram (kg). Cara yang paling efektif untuk menurunkan berat badan adalah perubahan gaya hidup meliputi diet dan olahraga. Selain diet rendah kalori, cara untuk mencegah kelebihan berat badan dan obesitas adalah puasa berselang.

Tujuan: Penelitian ini bertujuan untuk mengetahui pengaruh puasa berselang terhadap berat badan pada kelompok dewasa muda.

Metode: Penelitian ini menggunakan pretest-posttest groups control design yang dilakukan saat puasa Ramadhan 2017 di bagian Fisiologi Fakultas Kedokteran Universitas Udayana. Subjek penelitian dibagi menjadi dua kelompok yaitu kelompok puasa dan kelompok tidak puasa yang masing-masing berjumlah 40 orang. Data yang diambil meliputi berat badan sebelum dan sesudah puasa.

Hasil: Hasil uji normalitas didapatkan untuk kelompok puasa dengan p=0.326 dan kelompok tidak puasa p=0.317 yang berarti kedua kelompok homogen. Pada uji t-test berpasangan untuk berat badan awal dan akhir pada kelompok puasa didapatkan nilai p=0.000, sedangkan pada kelompok tidak puasa didapatkan nilai p= 0.149.

Simpulan: Puasa berselang berpengaruh terhadap penurunan berat badan awal dan berat badan akhir pada kelompok puasa. Sedangkan bagi kelompok tidak puasa, tidak didapatkan perbedaan yang bermakna antara berat badan awal dengan berat badan akhir.

Relationship Between Procalcitonin Serum Level and Septic Patient Mortality in Dr. Saiful Anwar General Hospital, Malang

Background: Procalcitonin is more frequently analyzed for sepsis diagnosis. Procalcitonin shows a tendency to increase as sepsis worsens. However, published studies investigating the correlation between procalcitonin and mortality in an adult patient with sepsis in Indonesia were lacking. This research aims to know the relationship between procalcitonin and mortality in sepsis.

Methods: A prospective cohort study was conducted in Dr. Saiful Anwar Public General Hospital, Malang, Indonesia from March to November 2018. During the study period, patients diagnosed with sepsis according to JAMA Sepsis-3 were tested for procalcitonin using Cobas e411 ECLIA method. The demographic and mortality data were acquired from the patients’ medical record. The statistical analysis was done with SPSS v.23, ? = 0.05.

Results: From a total of 69 subjects, 43 did not survive (62.32%). The procalcitonin serum level is significantly higher in the non-survivors than the survivors (37.77 ng/mL vs. 3.07 ng/mL, p=0.016). The Spearman’s rank correlation test showed r=0.293 (p=0.015). Using a cutoff point of 2 ng/mL, the relative risk is 2.77 (0.950-8.078).

Pengaruh kadar haemoglobin dan hematokrit dengan insiden kegagalan arteriovenous fistula pada pasien gagal ginjal kronik stadium V

Chronic Kidney Disease (CKD) is a disease that requires important attention. Chronic kidney failure is mentioned as kidney damage that occurs more or equal to 3 months in the form of abnormal structural or functional damage from the kidney with or without a decrease in GFR. Management of chronic renal failure is hemodialysis. Hemodialysis performed on patients with chronic renal failure requires appropriate vascular access.

Method: This study involved 76 respondents with a cross-sectional observation design in patients with stage V chronic kidney disease in Sanglah Hospital Denpasar from January 2018 to December 2018 conducted by arteriovenous fistula, with an age range of 17 years to 65 years, who have undergone regular hemodialysis for more than 3 month and with complete medical records.

Result: From this study it was found, characteristics based on age ? 55 years were 40 respondents (52.6%) and age <55 were 36 respondents (47.4%). Characteristics based on gender obtained male data as many as 43 respondents (56.6%) and women as many as 33 respondents (43.4%). Characteristics based on BMI obtained a median value of 26. Characteristics based on BMI ? 26 Kg / m2 were 39 respondents (51.3%) and BMI <26 Kg / m2 were 37 respondents (48.7%). Characteristics based on INR ? 1.2 were 10 respondents (13.2%) and INR 0.9-1.1 were 66 respondents (86.8%). Characteristics based on DM disease obtained with DM disease data as many as 17 respondents (22.4%) and without DM disease as many as 59 respondents (77.6%). Patients with hemoglobin hemoglobin levels <9.9 gr / dl with non-patent AVF 47 (73.4%) and ? 9.9 gr / dl with non-patent AVF 17 (26.6%) while hemoglobin levels <9, 9 gr / dl with patent AVF of 3 (25%) and ? 9.9 gr / dl with patent AVF of 9 (75%) [PR=1,4; IK1,07-1,91; p=0,001].

Conclusion: Hemoglobin <9.9 associated with failure of AVF. Low hemoglobin is the most important risk factor for the occurrence of AVF failure in CRF patients. Hematocrit <29.18 related to AVF failure.

Gagal Ginjal Kronik (GGK) merupakan penyakit yang memerlukan perhatian penting. Gagal ginjal kronik disebutkan sebagai kerusakan ginjal yang terjadi lebih atau sama dengan 3 bulan baik berupa kerusakan struktur atau fungsi yang abnormal dari ginjal dengan atau tanpa penurunan GFR yang dilakukan kepada pasien GGK memerlukan akses vaskular yang tepat.

Metode: Penelitian ini melibatkan 76 responden dengan rancangan observasi crossectional pada pasien  gagal ginjal kronis stadium V di RSUP Sanglah Denpasar dari mulai bulan Januari 2018 sampai Desember 2018 yang dilakukan arteriovenous fistula, dengan rentang umur 17 tahun sampai 65 tahun, yang sudah menjalani hemodialisis regular lebih dari 3 bulan dan dengan catatan medis yang lengkap. 

Hasil: Karakteristik berdasarkan umur ? 55 tahun sebanyak 40 responden (52,6%) dan umur < 55 sebanyak 36 responden (47,4%). Karakteristik berdasarkan jenis kelamin didapatkan data laki-laki sebanyak 43 responden (56,6%) dan perempuan sebanyak 33 responden (43,4%). Karakteristik berdasarkan BMI didapatkan nilai median 26. Karakteristik berdasarkan BMI  ? 26 Kg/m2 sebanyak 39 responden (51,3%) dan BMI < 26 Kg/m2 sebanyak 37 responden (48,7%). Karakteristik berdasarkan INR  ? 1,2 sebanyak 10 responden (13,2%) dan INR 0,9-1,1 sebanyak 66 responden (86,8%). Karakteristik berdasarkan penyakit DM didapatkan data dengan penyakit DM sebanyak 17 responden (22,4%) dan tanpa penyakit DM sebanyak 59 responden (77,6%).  Pasien dengan kadar haemoglobin Haemoglobin < 9,9 gr/dl dengan AVF tidak paten sebanyak 47(73,4%) dan  ? 9,9 gr/dl dengan AVF tidak paten sebanyak 17(26,6%) sedangkan kadar haemoglobin < 9,9 gr/dl dengan AVF  paten sebanyak 3 (25%)  dan  ? 9,9 gr/dl dengan AVF  paten sebanyak 9 (75%) [PR=1,4; IK1,07-1,91; p=0,001].

Simpulan: Hemoglobin < 9,9 berhubungan dengan kegagalan AVF. Haemoglobin yang rendah menjadi faktor risiko yang paling berperan terhadap terjadinya kegagalan AVF pada pasien GGK..Hematokrit < 29,18 berhubungan dengan kegagalan AVF. 

Sindroma emboli lemak pada kasus trauma orthopedi: sebuah tinjauan pustaka

Fat embolism (FE) is defined as fat embolism circulating in the bloodstream, with or without symptoms. Fat embolism syndrome (FES) is a circulatory fat embolism which is a secondary complication and causes specific clinical manifestations in the lungs, brain, skin. This incident is often found in orthopedic trauma, especially in long bone trauma, pelvis, and multiple trauma. In non-traumatic cases, such as hip or knee arthroplasty, FES may also be present. Gurd and Wilson's current criteria can help guide the diagnosis, but at this time there are no standardized diagnostic tests. There is no definitive therapy for FES and only supportive therapy.

 

 

Emboli lemak (FE) didefinisikan sebagai emboli lemak yang beredar di aliran darah, dengan atau tanpa gejala. Fat Embolism Syndrome (FES) adalah emboli lemak peredaran darah yang merupakan komplikasi sekunder dan menyebabkan manifestasi klinis spesifik di paru-paru, otak, kulit. Kejadian ini sering ditemukan pada trauma ortopedi, terutama pada trauma tulang panjang, trauma panggul, dan trauma multipel. Dalam kasus non-traumatis, seperti artroplasti pinggul atau lutut, FES juga mungkin dapat ditemukan. Kriteria Gurd dan Wilson saat ini dapat membantu memandu diagnosis, tetapi saat ini belum ada tes diagnostik standar. Tidak ada terapi definitif untuk FES dan hanya terapi suportif.

Gagal atrium kiri: terminologi yang perlu diketahui

Heart failure is the terminal stage of all the heart pathological conditions. The common understanding in heart failure is always preceded by left ventricular dysfunction. There are several clinical studies that indicate heart failure might occur without prior left ventricular dysfunction. Left atrial dysfunction may have more important roles than we previously thought in the context of heart failure. The atrium has a unique and different anatomical structure and function compared to the ventricles. Left atrial failure can occur independently of left ventricular dysfunction or mitral valve abnormalities. Atrial failure, similar to ventricular failure, could also cause or initiate global heart failure. The mechanism of atrial failure can be caused by fibrosis, electrical and mechanical dysfunction. Through this article, we would emphasize that atrial failure also has clinical significance and may explain heart failure with the condition of the sustained ejection fraction.

 

Gagal jantung adalah hasil akhir dari semua kondisi patologi di jantung. Terminologi umum dalam gagal jantung selalu didahului oleh disfungsi ventrikel kiri. Ada beberapa studi klinis yang menunjukkan gagal jantung mungkin terjadi tanpa disfungsi ventrikel kiri sebelumnya. Disfungsi atrium kiri mungkin memiliki peran penting lebih dari pada yang kita pikirkan sebelumnya pada kondisi gagal jantung. Berbeda dengan ventrikel, atrium memiliki struktur anatomis dan fungsi yang unik dan berbeda.  Gagal atrium kiri dapat terjadi secara independen terhadap disfungsi ventrikel kiri dan kelainan katup mitral. Seperti halnya ventrikel kiri, gagal atrium dapat menyebabkan gagal jantung secara global. Mekanisme gagal ventrikel dapat disebabkan dari fibrosis, disfungsi elektrik dan mekanik. Melalui artikel ini, kami akan menjelaskan bahwa kegagalan fungsi atrium juga memiliki signifikansi klinis dan mungkin menjelaskan gagal jantung dengan kondisi fraksi ejeksi yang dipertahankan.

Sistem skoring hematologi Rodwell sebagai metode diagnosis awal sepsis neonatorum di Rumah Sakit dengan fasilitas terbatas: sebuah tinjauan sistematis

Background: Neonatal sepsis is a major cause of morbidity and mortality in neonates with an incidence in Indonesia at about 8.7 to 30.29%. Blood culture as the gold standard for diagnosis is not available in all health care centers. An easy, fast and inexpensive diagnostic method is needed to overcome these problems. The diagnostic method that can be used is the Rodwell hematology scoring system (HSS). It uses seven hematologic parameters obtained through a complete blood count and peripheral blood smears examination. This systematic review aims to evaluate Rodwell HSS as a method for early diagnosis of neonatal sepsis in hospitals with limited facilities.

Methods: A systematic review of literature searching through the Cochrane Library, PubMed, and Google Scholar journal database was done by two reviewers. The inclusion criteria were studied about the diagnostic method for neonate's sepsis using Rodwell HSS and compared neonate's sepsis diagnostic method between Rodwell HSS and blood culture. The exclusion criteria were studies that were not published in English or Bahasa, not available in full text, and study with a case report, systematic review, or meta-analysis design.

Result: The hematological scoring system has the same sensitivity as its specificity. Sensitivity range is 80-100%, specificity 60.3-90%, PPV 26-73% and NPV 92.1-100%. A score of > 4 has an AUC value of 90.2%, which shows that this diagnostic test's accuracy is excellent.

Conclusion: The hematological scoring system with a score of > 4 gives the most rational and reliable results for the early diagnosis of neonatal sepsis. Due to its high sensitivity, specificity, and using simple examination, making these criteria suitable to use as a method for early diagnosis of neonatal sepsis, especially in limited health facilities hospital.

Latar belakang: Sepsis neonatorum merupakan penyebab utama morbiditas dan mortalitas pada neonatus dengan angka prevalensi di Indonesia 8,7 hingga 30,29%. Pemeriksaan baku emas untuk penegakkan diagnosis yaitu kultur darah, tidak tersedia di seluruh sentra layanan kesehatan. Sebuah metode diagnostik yang mudah, cepat dan murah diperlukan untuk mengatasi permasalahan tersebut yakni dengan sistem skoring hematologi (SSH) Rodwell. Tujuan tinjauan sistematis ini adalah mengevaluasi peran SSH Rodwell sebagai metode diagnosis dini sepsis neonatorum di rumah sakit dengan fasilitas terbatas.

Metode: Tinjauan sistematis berupa penelusuran literatur dilakukan oleh dua orang peneliti melalui database jurnal Cochrane Library, PubMed dan Google Scholar menggunakan operator Boolean. Kriteria inklusinya adalah studi mengenai metode diagnosis sepsis pada neonatus menggunakan SSH Rodwell dan membandingkan antara SSH Rodwell dengan kultur darah. Sedangkan kriteria eksklusinya studi yang terpublikasi tidak dalam bahasa Inggris atau Indonesia, tidak tersedia secara full-text dan desain studi berupa laporan kasus, tinjauan sistematis atau meta analisis.

Hasil: SSH Rodwell memiliki sensitivitas yang sama baiknya dengan spesifitasnya. Sensitivitas berada dalam rentang 80-100%, spesifisitas 60,3-90%, PPV 26-73% dan NPV 92,1-100%. Skor >4 memberikan nilai AUC 90,2% menunjukkan akurasi test diagnostik ini sangat baik.

Kesimpulan. SSH Rodwell dengan skor >4 memberikan hasil yang paling rasional dan reliabel untuk diagnosis awal sepsis pada neonatus. Penggunaan parameter yang sederhana menjadikan pemeriksaan ini cocok diaplikasikan pada rumah sakit dengan fasilitas kesehatan terbatas.

Positive calretinin stain with immunohistochemistry in a 49 year-old female with cardiac myxoma: A case report

Background: Primary tumors of the heart are scarce. Cardiac myxoma is a primary benign heart tumor most often found with an incidence of 0.5-1.0 cases per million population per year and 90% diagnosed in the fourth to seventh decades of life, rarely found in children. Cardiac myxoma is three times more common in women than in men. These tumors are mostly found in the left atrium.

Case description: Female, a 49-year-old patient, came with palpitations, shortness of breath, and weakness since the previous six months. On echocardiography, found a mass in the left atrium suspected of a left atrial myxoma. Surgery was performed, and the specimen was sent for histopathological examination. Macroscopically, the tumor mass shows an irregular shape, brownish color, and spongy consistency. Microscopic examination shows the tumor consisting of proliferation of spindle-shaped and stellate cells, with oval to round nuclei, eosinophilic cytoplasm, mostly scattered, some of which are arranged cord and nest, infiltrative between the myxoid stroma and partially surround small blood vessels to form a vasoformative ring. The specimen also contains the proliferation of blood vessels, extravasation of erythrocytes, and the distribution of inflammatory cells and hemosiderophages. The result of the immunohistochemical examination with calretinin was positive.

Conclusion: This case was concluded as cardiac myxoma based on clinical features, echocardiography, macroscopic, routine histopathological, and immunohistochemical examinations.

Pencitraan pada pankreolithiasis dengan pankreatitis kronis: laporan kasus

Background: Pancreolithiasis or pancreatic calculus is a rare case. Men suffer more than women with a ratio of 2-3:1 and have an incidence of 1-8:100.000. Pancretolithiasis itself is a sequela of chronic pancreatitis. Accompanied by non-specific complaints, epigastric abdominal pain that radiates to the back to the left shoulder and nausea, vomiting which causes weight loss and malnutrition. Radiological examination can help the clinician in. establish a diagnosis where the laboratory results are also not specific enough to diagnose chronic pancreatitis. The aim of this report is to determine the radiological features of pancreolithiasis accompanied by chronic pancreatitis.

Case: A 54-year-old woman with complaints of pain in the epigastric region for approximately 3 months, accompanied by nausea and vomiting, especially after eating which resulted in weight loss of approximately 10 kilograms. In laboratory tests, an increase in total cholesterol, LDH and hyperkalemia was found. There is no increase in amylase and lipase and hepatic function. On plain abdominal radiograph, ultrasound and CT scan, it is found that there is a stone image accompanied by imaging of chronic pancreatitis.

Conclusion: Pancreatic calculus is a rare condition. More common in male gender, patients with pancreolithiasis have non-specific discharge. Alcohol use is said to be the biggest factor in pancreolithiasis. On plain abdominal radiograph, ultrasound and CT scan can reveal the presence of stones in the pancreas and the presence or absence of involvement of the pancreatic parenchyma.